By Cuneyt Alper MD, Charles Bluestone MD, Margaretha Casselbrant, Joseph Dohar MD, Ellen Mandel MD
Complicated treatment of Otitis Media offers solutions to scientific care questions from the commonest difficulties to infrequent problems and sequelae of otitis media. The e-book ambitions clinicians who look after sufferers with a number of otolaryngological shows each day. each one bankruptcy within the e-book makes a speciality of an method of a particular scientific subject; diagnostic process; healing strategy; problem similar query; or controversy. The chapters describe the topic, prevalence, significance, etiology/pathogenesis, and administration ideas.
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Additional info for Advanced Therapy of Otitis Media
5 years, 60% did not cooperate; therefore, half of the tympanograms did not show any curve. Furthermore, type B curves were often false-positive. Therefore, the sensitivity of tympanometry was 71% and its specificity only 38% with myringotomy as a reference. On the contrary, among cooperative children, a type B curve showed sensitivity of 79% and specificity of 93%. In another survey among infants less than 1 year of age, tympanometry was successful in 94% of cases (Palmu et al, 1999). The sensitivity of a B curve in the detection of MEE was 82% and its specificity was 98% at nonacute visits when compared with myringotomy and/or pneumatic otoscopy.
If the middle ear is filled with air, signs of negative pressure should be evi- FIGURE 3-13. Otitis externa. Examination of the Tympanic Membrane for Otitis Media / 19 FIGURE 3-14. Surface inflammation of the eardrum (weeping myringitis). FIGURE 3-16. Moist central perforation. FIGURE 3-15. Clean central subtotal perforation. FIGURE 3-17. Squamous debris or granulation overlying the mouth of a retraction pocket cholesteatoma. denced on insufflation and the pocket may be disproportionately mobile.
GR = tympanometric width; MEE = middle ear effusion; TPP = tympanometric peak pressure; YA = static admittance. 12 / Advanced Therapy of Otitis Media (Palmu et al, 2001). The probability of MEE increased with decreasing static admittance and tympanometric peak pressure. However, interestingly, in the few cases of a type C curve connected to MEE, the bacterial culture mainly remained negative, and MEE was serous and of small volume and thus did not significantly affect hearing (Koivunen et al, 1997; Koivunen et al, 2000; Palmu et al, 2001).